It turns out that when it comes to heartburn, new research is showing that taking a pill may be unhealthy and even unsafe.
For the millions who rely on Nexium, Prilosec, Prevacid or other medications, this is likely exasperating and frustrating news, since living with regular heartburn is no picnic.
These drugs typically are very effective in relieving or reducing the painful, annoying symptoms of “gastrointestinal reflux disease,” or GERD.
For years, physicians thought the drugs were safe. But over the last few years, research has found that these drugs, also called “protein pump inhibitors,” or “PPIs,” alter the chemistry in the stomach, creating the risk for infections, food poisoning, pneumonia, serious nutrient deficiencies, decreased bone strength, and even the potentially fatal digestive system infection called “clostridium difficile.”
And just yesterday, a study of almost 75,000 patients published in JAMA Neurology concluded that “the avoidance of PPI medication may prevent the development of dementia.” Those taking PPI meds had a significantly higher risk of dementia as opposed to those not taking the drugs.
How Does Heartburn Happen?
Initially, there’s a trigger, maybe it’s stress, or a long night of partying, or too much acidic food. The first time it strikes you might find yourself burping a lot, or feeling intense pressure in your chest area, or sensing burning regurgitation in throat. It can be frightening. Sometimes it’s a one-off; you take a couple of chewable anti-acid pills and you’re fine.
Frequently, it continues. That’s because the extra acid — whatever caused it — burns the tender valve of your esophagus, making it a less-effective “trap door” between your stomach and your throat. Unless the esophagus gets about two or three months of a low-acid environment, it won’t heal. So the discomfort continues.
That’s unless you find a way to reduce the stomach acid and stop irritating the stomach and esophagus. PPIs do that because they reduce the amount of acid the stomach manufactures. But as we now know, there are serious side effects from using drugs to change the natural process of the stomach.
But Take Heart: There’s Another Way
I had a bad case of heartburn a few years ago and knew I didn’t want to start taking medication. For the vast majority of people, research shows that a combination of lifestyle changes can stop the cycle and reduce or stop your symptoms. But it takes about two or even three months of vigilance:
- No alcohol for two months. Honestly. Alcohol stimulates stomach acid and can itself irritate the damaged esophageal valve. Once your heartburn symptoms go away, you can gradually re-introduce a little alcohol at a time back into your life, if you wish, and see how you do. If you have more heartburn, give the alcohol a rest and try again in a few weeks.
- Avoid fatty and/or spicy foods. Your stomach acid increases when fat and spicy food enters the stomach. You can help the healing process along by avoiding as much fat as possible. That may mean initially cutting out red meat, desserts, higher-fat salad dressings, butter and most cheese. As with alcohol, after a few months, slowly re-introduce those foods back into your diet and see how it goes. I tried a yogurt-made dressing when I was fighting heartburn and I like it so much, I’m still using it.
- Avoid citrus, including orange juice, lemons and lemonade. (Oddly, even though I’ve been heartburn-free for years, a sip of lemonade still gives me a bit of discomfort). Apple and cranberry juice may be good substitutes.
- Eat smaller meals. When you stomach is full, it produces more acid. Eat less at a sitting. Have a half a sandwich for lunch, and then an apple a few hours later.
- Try sleeping with your head elevated. That’s because when your esophageal valve is injured from acid, it doesn’t close tightly. So if you’re lying flat in bed, it’s easier to have stomach acid flow toward the valve, burning it, and re-irritating it.
- No soft drinks or coffee. Even decaffeinated coffee is usually irritating. That’s because it’s a bit acidic. That’s the problem with soft drinks, too: they can stimulate acid production.
- Drink plenty of water. Practically, you have to because this list has virtually eliminated every other fluid. But water also helps dilute the acid.
- Lose weight. You probably will anyway just by reducing fat and alcohol. Extra weight can push against your stomach, increasing the chances acid will irritate your esophagus.
- Be kind to yourself. The anti-heartburn diet is no fun. So reward yourself with other treats, whatever makes you happy. Avoid stress or find a way to talk about it with someone you love. Take a walk.
If you still are uncomfortable, be sure to talk to your physician and decide what is best for you.